综合性ICU医院感染的调查分析与管理  

Investigation and analysis of nosocomial infections in general ICUs and measures of infection control

作　　者：吴玲丽[1] 张娟[2] 孙迎芳 

机构地区：[1]杭州市余杭区中医院护理部,浙江杭州311106 [2]杭州市余杭区中医院ICU,浙江杭州311106 [3]杭州市余杭区中医院院感科,浙江杭州311106

出　　处：《中华医院感染学杂志》2015年第1期114-115,124,共3页Chinese Journal of Nosocomiology

基　　金：浙江省科技局基金资助项目(2011015);浙江省杭州市科技局基金资助项目(20110833B48)

摘　　要：目的探讨综合性ICU患者发生医院感染病原菌分布及耐药性,并总结有效的感染管理措施,以降低ICU医院感染的发生率。方法选取2010年12月-2012年12月ICU收治的198例患者进行研究,分析医院感染情况,以及感染患者的病原菌分布及耐药性。结果 198例患者术后发生医院感染23例,感染率为11.62%;共培养出病原菌31株,其中革兰阴性菌20株占64.52%,革兰阳性菌9株占29.03%,真菌2株占6.45%;病原菌对常用抗菌药物表现出不同程度的耐药性,铜绿假单胞菌对常用抗菌药物耐药率较低,对头孢曲松、头孢唑林的耐药率较高,均达100.00%,金黄色葡萄球菌对青霉素的耐药率较高,均达100.00%。结论 ICU医院感染以革兰阴性菌为主,但革兰阳性菌及真菌已成为重要致病菌,且耐药率明显升高;应加强ICU感染管理和病原菌耐药性的监测,合理使用抗菌药物,制定有效对策,降低医院感染的发生。OBJECTIVE To explore the distribution and drug resistance of pathogens causing nosocomial infections in patients of the general ICU and put forward effective infection control measures so as to reduce the incidence of nosocomial infections in the ICU.METHODS A total of 198 patients who were treated in the ICU from Dec 2010 to Dec 2012 were enrolled in the study,the incidence of nosocomial infections was analyzed,and the distribution and drug resistance of the pathogens causing infections were observed.RESULTS The postoperative nosocomial infec-tions occurred in 23 of 198 patients with the infection rate of 11.62%.A total of 31 strains of pathogens have been cultured,including 20 （64.52%）strains of gram-negative bacteria,9 （29.03%）strains of gram-positive bacteria, and 2 （6.45%）strains of fungi.The pathogens varied in the drug resistance to the commonly used antibiotics;the drug resistance rate of the Pseudomonasaeruginosa to the commonly used antibiotics was low,and the drug resist-ance rates to ceftriaxone and cefazolin were as high as 100.00%;the drug resistance rate of the Staphylococcus aureus to penicillin reached as high as 100.00%.CONCLUSION The gram-negative bacteria are the predominant pathogens causing nosocomial infections in the ICU patients,however,the gram-positive bacteria and fungi have become the leading pathogens,of which the drug resistance rates are significantly increased.It is necessary to strengthen the infection control in the ICU and the surveillance of drug resistance,reasonably use antibiotics,and put forward effective countermeasures so as to reduce the incidence of nosocomial infections.

关 键 词：重症监护病房 医院感染 管理 

分 类 号：R181.32[医药卫生—流行病学]